Brief Answer:
Tests are needed to determine etiology.

Detailed Answer:
Good Day and thank you for being with Healthcare Magic!

WBC is the presence of pus cells in the urine (pyuria) and can be found most commonly in the presence of urinary tract infection (UTI) but can also found in numerous inflammatory conditions. Examples of these would be urethral syndrome, tuberculosis of the urinary tract, diabetes, interstitial nephritis and interstitial cystitis.

First and foremost I would recommend a urine culture for typical and atypical bacteria. Urine culture is the gold standard in the detection of urinary tract infection and usually catches 90% of the infection. Polymerase chain reaction (PCR) is also a valuable accurate test to rule out chlamydia and other organisms that will not grow on culture. If the organism is detected then the appropriate treatment will be started to eradicate the infection.

Once infection has been ruled out then other causes of pyuria will be entertained. Do you have voiding complaints? urinary frequency? urinary urgency? weak urinarystream? I am concerned about your chronic cystitis and thickened bladder wall which may be due to obstruction. Due to your advanced age I am likely to think that you may have atrophic urethritis due to menopause. Atrophic urethritis leads to chronic obstruction the bladder causing thickening of the bladder and will definitely have inflammatory cells or pus cells in the urine.

Treatment for atrophic urethritis would start with vaginal estrogen suppositories and estrogen creams to the urethra to regain the normal lining of the urethra. If there is no improvement after a few months then an outpatient procedure can be done to dilate/open the urethra to relieve the obstruction.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.

Regards,

Manuel C. See IV, M.D. DPBU FPUA

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Brief Answer:
It is a uropathogen and can be treated with abx.

Detailed Answer:
Good Day and thank you for being with Healthcare Magic!

yes citrobacter is not uncommon pathogen of the urinary system and can be treated with the usual antibiotics. the sensitivity results will tell us which antibiotic would be appropriate for the bacteria. most probably the bacteria is already resistant to ciprofloxacin and your Urologist will prescribe a different antibiotic that is based on the culture.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.

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